IL-1, IL-6, TNF-α, and MIF in relative adrenal insufficiency in septic shock: a piglet model

Authors

  • Bina Akura Fatmawati Hospital, Jakarta, Indonesia
  • Jose R. L. Batubara Department of Pediatric, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
  • Zakiudin Munasir Department of Pediatric, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
  • Gunanti Department of Surgery and Radiology, Faculty of Veterinary Medicine, Institut Pertanian Bogor, Bogor, Indonesia
  • Joedo Prihartono Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
  • Hindra Irawan Satari Department of Pediatric, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
  • Suzanna Immanuel Department of Clinical Pathology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
  • Dadang Hudaya Somasetia Department of Pediatric, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia

DOI:

https://doi.org/10.13181/mji.oa.202943

Keywords:

adrenal insufficiency, interleukin-1, interleukin-6, macrophage migration inhibition factors, septic shock, tumor necrosis factor-alpha

Abstract

BACKGROUND Inflammatory mediators released during septic shock are involved in the mechanism of adrenal insufficiency. This study investigated the role of interleukin (IL)-6, IL-1, tumor necrosis factor (TNF)-α, and macrophage migration inhibitory factor (MIF) in septic shock with relative adrenal insufficiency (RAI).

METHODS We conducted a 6-month experimental study in 20 piglets. Following endotoxin administration, their hemodynamics were monitored and blood samples were drawn to test the levels of cytokines IL-1, IL-6, TNF-α, and MIF every 15 min until septic shock onset as well as during a corticotropin stimulation test. Septic shock was managed by administering fluid resuscitation, inotropic drugs, and hydrocortisone. At the end of the study, the piglet models were classified as either RAI or non-RAI. Immunohistochemistry staining was performed on the hypothalamus of the RAI group.

RESULTS The level of IL-6 at 45 min was higher in the RAI group than the non-RAI group (p = 0.008), and that of IL-1 was similar in the two groups during septic shock. The RAI group had higher TNF-α levels at 15 min (p = 0.002) and at 30 min (p = 0.007) than the non-RAI group, and the MIF level during septic shock was higher in the RAI group (p = 0.003) than the non-RAI group.

CONCLUSIONS Cytokine-induced inflammatory process of adrenal gland reflected in TNF-α level in 15 min and 30 min, IL-6 in 45 min, and MIF in septic shock condition but not in IL-1.

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References

Latief A, Chairulfatah A, Alam A, Pudjiadi AH, Somasetia DH, Djatnika Setiabudi D. Diagnosis and management of sepsis in children. In: Latief A, editor. National Guidelines for Medical Services IDAI. 1st ed. Jakarta: IDAI; 2016. p. 1-47. Indonesian.

Vila-Pérez D, Jordan- García L. Relative adrenal insufficiency in pediatric septic shock. J Pediatr Intensive Care. 2015;4(3):129-37. https://doi.org/10.1055/s-0035-1559821

Linck Júnior A, Rego Filho Ede A, Moriya LK, Cardoso JR. Adrenal insufficiency in children with sepsis. Rev Bras Intensiva. 2011;23(4):478-83. https://doi.org/10.1590/S0103-507X2011000400013

Widodo AD, Tumbelaka AR. Use of steroids in the management of sepsis in an evidence-based case analysis. Sari Pediatri. 2010;11(6):387-94. Indonesian. https://doi.org/10.14238/sp11.6.2010.387-94

Silverman MN, Sternberg EM. Glucocorticoid regulation on inflammation and its functional correlates: from HPA axis to glucocorticoid receptor dysfunction. Ann N Y Acad Sci. 2012;1261:55-63. https://doi.org/10.1111/j.1749-6632.2012.06633.x

Van den Berghe G. Novel insights in the HPA-axis during critical illness. Acta Clin Belg. 2014;69(6):397-406. https://doi.org/10.1179/2295333714Y.0000000093

Grieb G, Merk M, Bernhagen J, Bucala R. Macrophage migration inhibitory factor (MIF): a promising biomarker. Drug News Perspect. 2010;23(4):257-64. https://doi.org/10.1358/dnp.2010.23.4.1453629

Stevens JP, Haase E, Churchill T, Bigam DL, Cheung PY. Resuscitation with 21% or 100% oxygen is equally effective in restoring perfusion and oxygen metabolism in the liver of hypoxic newborn piglets. Shock. 2007;27(6):657-62. https://doi.org/10.1097/shk.0b013e31802b63a4

Chapados I, Chik CL, Cheung PY. Plasma cortisol response to ACTH challenge in hypoxic newborn piglets resuscitated with 21% and 100% oxygen. Shock. 2010;33(5):519-25. https://doi.org/10.1097/SHK.0b013e3181c99727

Dewi R, Supriyatno B, Madjid AS, Gunanti, Lubis M. The effects of colloids or crystalloids on acute respiratory distress syndrome in swine (Sus scrofa) models with severe sepsis: analysis on extravascular lung water, IL-8, and VCAM-1. Med J Indones. 2016;25(1):33-8. https://doi.org/10.13181/mji.v25i1.1204

Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock. Crit Care Med. 2013;41(2):580-637. https://doi.org/10.1097/CCM.0b013e31827e83af

Stenman UH. Standardization of hormone determinations. Best Pract Res Clin Endocrinol Metab. 2013;27(6):823-30. https://doi.org/10.1016/j.beem.2013.10.007

Boonen E, Van den Berghe G. Endocrine responses to critical illness: novel insights and therapeutic implications. J Clin Endocrinol Metab. 2014;99(5):1569-82. https://doi.org/10.1210/jc.2013-4115

Singh SN, Rathia SK, Awasthi S, Singh A, Bhatia V. Salivary cortisol estimation to assess adrenal status in children with fluid unresponsive septic shock. Indian Pediatr. 2013;50(7):681-4. https://doi.org/10.1007/s13312-013-0190-1

Menon K, Ward RE, Lawson ML, Gaboury I, Hutchison JS, Hébert PC; Canadian Critical Care Trials Group. A prospective multicentre study of adrenal function in critically ill children. Am J Respir Crit Care Med. 2010;182(2):246-51. https://doi.org/10.1164/rccm.200911-1738OC

Rady HI, Aly YS, Hafez M, Bazaraa HM. Adrenocortical status in infants and childrenwith sepsis and septic shock. Gaz Egypt Paediatr Assoc. 2014;62(1):18-23. https://doi.org/10.1016/j.epag.2014.02.001

Hebbar kB, Stockwell JA, Leong T, Fortenberry JD. Incidence of adrenal insufficiency and impact of corticosteroid supplementation in critically ill children with systemic inflammatory syndrome and vasopressor-dependent shock. Crit Care Med. 2011;39(5);1145-50. https://doi.org/10.1097/CCM.0b013e31820eb4e4

Rachmawati RI, Widodo DP, Tridjaja B, Pudjiadi AH. Adrenal function in sepsis in a pediatric intensive care unit. Sari Pediatri. 2011;12(6):426-32. Indonesian. https://doi.org/10.14238/sp12.6.2011.426-32

Téblick A, Peeters B, Langouche L, Van den Berghe G. Adrenal function and dysfunction in critically ill patients. Nat Rev Endocrinol. 2019;15:417-27. https://doi.org/10.1038/s41574-019-0185-7

Annane D. The role of ACTH and corticosteroids for sepsis and septic shock: an update. Front Endocrinol (Lausanne). 2016;7:70. https://doi.org/10.3389/fendo.2016.00070

Schulte W, Berrnhagen J, Bucala R. Cytokines in sepsis: potent immunoregulators and potential therapeutic targets-an updated view. Mediators Inflamm. 2013;2013;165974. https://doi.org/10.1155/2013/165974

Matsumoto H, Ogura H, Shimizu K, Ikeda M, Hirose T, Matsuura H et al. The clinical importance of a cytokine network in the acute phase of sepsis. Sci Rep. 2018;8:13995. https://doi.org/10.1038/s41598-018-32275-8

Song J, Park DW, Moon S, Cho HJ, Park JH, Seok H, et al. Diagnostic and prognostic value of interleukin-6, pentraxin 3 and procalcitonin levels among sepsis and septic shock patients: a prospective controlled study according to the sepsis-3 definitions. BMC Infect Dis. 2019;19(1):968. https://doi.org/10.1186/s12879-019-4618-7

Karrow NA, You Q, McNicoll C, Hay J. Activation of the ovine hypothalamic-pituitary-adrenal axis and febrile response by interleukin-6: a comparative study with bacterial lipopolysaccharide endotoxin. Can J Vet Res. 2010;74(1):30-3.

Chuang Ty, Chang HT, Chung KP, Cheng HS, Liu CY, Liu YCet al. High levels of serum macrophage migration inhibitory factor and interleukin 10 are associated with a rapidly fatal outcome in patients with severe sepsis. Int J Infect Dis. 2014;20:13-7. https://doi.org/10.1016/j.ijid.2013.12.006

Published

2020-10-05

How to Cite

1.
Akura B, Batubara JRL, Munasir Z, Gunanti, Prihartono J, Satari HI, Immanuel S, Somasetia DH. IL-1, IL-6, TNF-α, and MIF in relative adrenal insufficiency in septic shock: a piglet model. Med J Indones [Internet]. 2020Oct.5 [cited 2024Nov.24];29(3):250-9. Available from: https://mji.ui.ac.id/journal/index.php/mji/article/view/2943

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Section

Basic Medical Research
Abstract viewed = 873 times

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